title: Suction cup/contact lens complications following penetrating keratoplasty.
abstract: OBJECTIVE
  Rigid gas permeable (RGP) contact lenses facilitate visual rehabilitation in cases of high or irregular corneal astigmatism following penetrating keratoplasty. A variety of plunger-like suction cup devices are available to assist in the removal of these lenses.
  
  
  METHODS
  We report three patients with serious complications associated with the use of a suction cup device for contact lens removal following penetrating keratoplasty.
  
  
  RESULTS
  Two patients suffered corneal wound dehiscence following contact lens removal; one contact lens was removed by the patient's spouse and the other was removed by a trained technician. A third patient triggered a graft rejection, and ultimately, graft failure, after a vigorous attempt at lens removal.
  
  
  CONCLUSIONS
  Forces generated by suction cup devices during removal of RGP contact lenses are sufficient to cause significant trauma. Contact lenses with an apical clearance fit may augment these forces, with the potential for complications following penetrating keratoplasty.
authors.affiliation: Department of Ophthalmology, Geisinger Medical Center, Danville, PA 17822, USA.
authors.forename: H J
authors.initials: HJ
authors.lastname: Ingraham
authors.forename: H D
authors.initials: HD
authors.lastname: Perry
authors.forename: A B
authors.initials: AB
authors.lastname: Epstein
authors.forename: E D
authors.initials: ED
authors.lastname: Donnenfeld
authors.forename: T D
authors.initials: TD
authors.lastname: Gwin
authors.forename: A N
authors.initials: AN
authors.lastname: Carlson
authors.forename: K
authors.initials: K
authors.lastname: Moadel
authors.forename: R E
authors.initials: RE
authors.lastname: Mariani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003261:Contact Lenses / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology* / Q000601:surgery; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D012086:Reoperation; D013396:Suction / Q000009:adverse effects* / Q000295:instrumentation; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000601:surgery; D014792:Visual Acuity